A 7-year-old boy with sickle cell disease presents with sudden onset pallor, fatigue, and dark urine. Hemoglobin is 4.2 g/dL with reticulocyte count of 0.1%. Bone marrow shows giant pronormoblasts with viral inclusions. Which virus is most likely responsible?

• A Epstein-Barr virus
• B Hepatitis C virus
• C Cytomegalovirus
• D Parvovirus B19 ✓

Explanation

Parvovirus D19 infects erythroid progenitor cells via the P antigen (globoside) receptor, causing transient aplastic crisis in patients with increased red cell turnover such as sickle cell disease. The bone marrow typically shows giant pronormoblasts with viral inclusions. EBV, CMV, and HCV do not cause this specific presentation of pure red cell aplasia.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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